Characteristic differences in cephalic arch geometry for diabetic and non-diabetic ESRD patients

Abstract

Based on this study, it was found that there are two distinct types of cephalic arch geometries. Patients having diabetes mellitus show a significant probability of having a larger R/d ratio and wider arch angle. This study has given insight into structural alterations in geometry of the cephalic arch of diabetics with brachiocephalic fistula access.

Evaluating and treating venous outflow stenoses is necessary for the successful open surgical treatment of arteriovenous fistula aneurysms

“…Cephalic arch stenosis is presumed secondary to the course of the vein within the deltopectoral groove. 14 In addition, repeated punctures to access the AVF during HD treatments also leads to vessel injury and continued dilatation, eventually leading to aneurysmal formation. 9…”

A pressure-gradient mechanism for vortex shedding in constricted channels

“…Low aspect ratio constrictions appear to be common in stenotic flows. For example, a review by Hammes et al 26 found that stenoses often have widths close to the vessel diameter.…”

Venous Outflow Stenosis of the Brachiocephalic Fistula: A Single Entity, or is the Cephalic Arch Different?

“…Despite this, a lower than predicted incidence of diabetes in those with cephalic arch stenosis has been a consistent finding in multiple other studies [5,20,15]. Hammes et al have proposed that patients with diabetes have a wider cephalic arch than those without, thus reduced haemodynamic stress in this area [21]. Certainly it appears that the tight angle of the cephalic arch, with localised turbulent flow, may play an overwhelming role in the development of stenosis, overwhelming traditional risk factors implicated in vascular stenosis formation.…”